This research verified the applicability and effectiveness of the ultrasonic monitoring of sediments stuck on the inner wall of polyvinyl chloride (PVC) pipes. For identifying the transmittance of acoustic energy and the speed of sound in the PVC material, the pulse-echo ultrasonic testing was conducted for PVC sheets of different thicknesses. To simulate the solidified sediment, the hot melt adhesive (HMA) was covered on the inner wall of the PVC pipe in different heights. From the experiment, the speeds of sound in the PVC and the HMA materials were obtained as about 2258 and 2000 m/s, respectively. The thickness of the materials was calculated through the signal processing such as taking the absolute value and low pass filtering, the echo detection, and the measurement of the time of flight. The errors between actual and measured thicknesses of PVC sheets were below 5%. In the case of the substance stuck on the inner wall, the errors were below 2.5%. Since the pulse-echo ultrasonic inspection is available on the outer surface and its measurement accuracy was over 95%, it can be an efficient and effective in-service structural health monitoring for the sediment on the wall of PVC pipes.